Provider Demographics
NPI:1760965487
Name:HEIM, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:HEIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:ELMER
Mailing Address - State:NJ
Mailing Address - Zip Code:08318-2143
Mailing Address - Country:US
Mailing Address - Phone:856-690-1616
Mailing Address - Fax:856-896-6107
Practice Address - Street 1:330 FRONT ST
Practice Address - Street 2:
Practice Address - City:ELMER
Practice Address - State:NJ
Practice Address - Zip Code:08318-2143
Practice Address - Country:US
Practice Address - Phone:856-690-1616
Practice Address - Fax:856-896-6107
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-09
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist